In the past recent years, the way patient care is delivered has undergone significant changes and challenges in accessibility. In Canada, primary care is the main entrance to health care for people with chronic diseases [1, 2, 3]. The growth rate of the aging population and people living with chronic disease are well noticeable by the government and by the primary care practice teams [4]. Accessibility to primary care is getting more complicated due to the complexity of patient conditions and the rise in demand for healthcare professionals. Digital healthcare technology is experiencing a surge in popularity, being embraced both within clinical care and research [5, 6]. Physicians' adoption rates of handheld computers range from 45–85% [7]. Digital medical history tools, also known as computer-assisted history-taking systems are software programs that allow patients to provide their medical history electronically before the consultation. This can be done in different contexts (ex; remotely, via a web-based portal, or on-site, etc.) [8]. Moreover, digital medical history-taking holds promise in mitigating the limitations of traditional practices. Firstly, patient recollections can be inconsistent due to challenges in comprehension, recall, evaluation, and verbal articulation [8, 9, 10]. Secondly, physician bias based on gender, race, or culture could introduce inappropriate variations in questioning, acting as barriers to comprehensive medical history collection [9, 11].
Supported by both theoretical and empirical evidence, digital medical history-taking proves effective in overcoming these limitations and more. Firstly, digital systems for medical history-taking possess the capacity to gather a more comprehensive range of information compared to what is achievable in face-to-face consultations [8]. This potential enhancement could yield deeper insights into potential risk factors and potentially offer a more accurate preliminary understanding of unique patient needs before the patient's visit [12, 13, 14]. Secondly, it optimizes the utilization of face-to-face consultation time by pre-emptively identifying existing conditions and information about presenting issues before the patient arrives at the physician's office [14, 15]. This avoids repeating the patient's story at every consultation. This redirection of effort from history-taking to discussing management strategies, fostering rapport, and focusing on patient relationships streamlines the consultation process. Thirdly, digital history-taking enhances data quality [12–16], in turn bolstering the diagnostic process. The accuracy of information accessible to the primary care provider significantly influences the quality of diagnosis. Fourthly, digital medical history-taking integrates more up-to-date information, including data from tests and other healthcare providers, contributing to the continuity of information across various healthcare providers [17]. What's more, virtual tools can facilitate information sharing between healthcare professionals and patients, which has a positive influence on interprofessional collaboration [8, 18]. Taken together, these improvements, in turn, have the potential to enhance patient engagement in shared decision-making processes, effectively bridging the gap between patients and healthcare providers.
Digital medical history taking has garnered strong favorability among patients as well. In a comprehensive review conducted by Dale & Hagen (2007), it was established that digital questionnaires outshine traditional paper-based counterparts across various dimensions including feasibility, user satisfaction, and data accuracy [19]. This favorable outcome was corroborated in another study, where participants from a pulmonary outpatient clinic were provided with a dynamic multilingual questionnaire [20]. Impressively, over 80% of respondents found the digital tool more convenient than traditional pen-and-paper methods. Moreover, 93% of the participants perceived the tool as "helpful" or "rather helpful," with 89% recognizing the advantage of completing the questionnaire before their interaction with the physician [20]. The widespread positivity surrounding digital questionnaires has been consistently echoed across multiple investigations [19–24].
Furthermore, a range of studies have indicated that sensitive or intimate personal information can be more effectively gathered through computer-based questionnaires [25]. Notably, patients were found to be more candid when using computer-assisted questionnaires as opposed to traditional doctor-patient interviews, as exemplified in scenarios like collecting HIV risk factors [26–28] with over 83% of patients in a study led by Arora et al. expressing a preference for addressing sensitive questions via digital questionnaires rather than in person [7].
From a technical standpoint, prior research has demonstrated remarkable ease of use, with around 85 to 93% of adult study participants encountering no technical issues when employing digital questionnaires [29, 30]. Furthermore, evaluations of user-friendliness indicate that approximately 97% of the patients would opt to complete digital questionnaires in the future. Impressively, around 94% of the patients believed that the digital questionnaire format aided in structuring their thoughts and predicted a positive impact on their treatment outcomes [7].
FirstHx is currently collaborating and has toolkits available as part of eVisitNB, but deployment in primary care clinics remains challenging due to our limited understanding of the needs, culture and acceptability of triage for the francophone population.
Aims and objectives
The purpose of this study is to evaluate the validity and user satisfaction of the digital medical history tool used by FirstHx at the French-language level in primary care. This project will be conducted in two phases. To achieve this goal, this research project will have two specific objectives:
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Evaluate the validity of the digital medical history tools used by FirstHx at the French-language level;
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Evaluate user satisfaction with this tool.